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surgical skills > questions > Flashcards

questions Flashcards

1
Q

Most commonly used knot in surgery

A

Square knot

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2
Q

Square knots are composed of

A

2 simple throws

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3
Q

How does a surgeons knot allow for greater knot security?

A

Higher knot friction

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4
Q

How is a knot always secured?

A

By tying 2 additional throws minimum

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5
Q

What type of knot is useful for tying knots in deep cavities or tight spaces ?

A

Slip knot

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6
Q

Knot security is inversely related to _______

A

the diameter of the suture material

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7
Q

Suture end should be cut short (3mm)….What is the exception to this?

A

Surgical gut –> 6mm due to swelling

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8
Q

Stabilizes tissue &/or expose tissue layers during suturing

A

Thumb forceps

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9
Q

Used for delicate grasp of skin & fascial planes

A

Adson thumb forceps

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10
Q

General tissue manipulation & handling needle during suturing

A

Adson Brown thumb forceps

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11
Q

Stabilize & retract less delicate tissues

A

Rat-tooth thumb forceps

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12
Q

Grasps more dense tissues

A

Allis tissue forceps

type of ratcheted forceps

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13
Q

Grasping intestines or other hollow organs

A

Babcock tissue forcepst

type of ratcheted forcep

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14
Q

Used for intestinal R & A, gastric sx

R & A - retraction and anastomoses???

A

Doyen intestinal forceps

ratcheted forcep

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15
Q

Control point bleeders

A

Halstead/Mosquito Hemostatic Forceps

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16
Q

Hemostasis of larger vessels

A

Kelly Hemo. Forceps

Crile Hemo. Forceps

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17
Q

Rochester - Carmalt Hemo. Forceps –> aids in hemostasis by _____

A

crushing ovarian pedicles and/or uterus during OHE

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18
Q

Exerts gentle compression of vessel without causing endothelial damage for the purpose of temporary hemostasis (ex. vena cava)

A

Bulldog satinsky and satinsky hemo. forceps

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19
Q

used to cut suture material

A

Doyen scissors

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20
Q

Delicate tissue dissection

A

Metzenbaum

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21
Q

Cut more dense tissue

A

Mayo scissors

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22
Q

Retract skin and superficial tissues to improve visualization & accessibility of deeper tissues

A

Self retractors

ex. Gelpi, Weitlaner

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23
Q

Hold abdominal cavity open

A

Balfour retractors

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24
Q

Hand-held retraction of skin and superficial muscle layers

A

Senn-Miller
Parker
Army-Navy

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25
Q

Suture pattern that brings edges together

A

Appositional

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26
Q

When would you use an appositional suture pattern?

A

when no excessive tension on skin

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27
Q

Suture pattern - edges turned inward

A

Inverting

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28
Q

When would you use an inverting pattern?

A

Use on hollow organs to minimize risk of luminal leakage

29
Q

Suture pattern - edges turn upward

A

Everting

30
Q

When would you use everting suture pattern?

A

Use in areas under tension

31
Q

What are the goals of suturing?

A 
Revert tissue to its normal position
Close dead space
Appose like-tissues
Avoid eversion or inversion when closing skin
Symmetry
32
Q

Why would you want to avoid eversion of inversion when closing skin?

A

Delays healing

33
Q

Elimination of ALL microbes on an inanimate object

A

Sterilization

34
Q

Reduction of microbial load on inanimate object

A

Disinfection

35
Q

Reduction of microbial load on animate (living) object

A

Antisepsis

36
Q

What are the 2 types of sterilization?

A

Physical

Chemical

37
Q

Agents of physical sterilization?

A

Heat (steam)
Filtration
Ionizing radiation

38
Q

Agents of chemical sterilization?

A 
Ethylene oxide 
Gas plasma (H2O2)
39
Q

*Most reliable means of sterilization (steam steril.)

A

Autoclave

40
Q

What is microbial death dependent upon with autoclaving?

A

Time
Temp
Pressure

41
Q

*What is the fxn of sterilization indicators?

A

Method of monitoring the effectiveness of the sterilization process

42
Q

Only way to ensure sterility following sterilization

A

Biological sterilization indicators

43
Q

Limitations of radiation sterilization

A

Some plastics & pharmaceuticals

44
Q

Cannot attain sufficient temperature for sterilization

A

Ineffective sterilization (ex boiling water)

45
Q

*Efficiency of Ethylene oxide (EtO) chemical sterilization is dependent upon

A

Temperature (120-140 F)
Concentration
Exposure time (4 hr min)
Humidity (20-40% ideal)

46
Q

*What is the limitation of chemical sterilization w/ Ethylene oxide?

A

TOXIC!

aeration is essential

47
Q

Safe level of EtO vs Olfactory detection of EtO

A

Safe level = 10ppm

Olfactory detection = 700ppm

48
Q

Toxic effects of EtO

A

CNS depression
Irritation of skin/eyes/mucous membranes
Probable carcinogen

49
Q

Type of sterilization that does not require aeration?

A

Gas plasma - rapid sterilization (1 hr)

50
Q

#1 option to sterilize heat-sensitive items

A

Gas plasma

low temp sterilization & no harmful emissions

51
Q

Limitations of gas plasma sterilization

A

gas cannot penetrate walls of items that have lumens (unless used w/special adaptor)

52
Q

Which instruments would you use cold sterilization on?

A

Frequent-use instruments
Instruments that can’t tolerate high heat or have lenses
ET tubes
Anesthetic machine hoses

53
Q

Cold sterilization requires what time length for immersion

A

minimum of 3 hrs of immersion

54
Q

If use Glutaraldehyde 2%, what must you do before using the instrument

A

it is and irritant

so must rinse with distilled water or sterile saline and dry with a sterile towel before use

55
Q

Chemical agents that reduce microbial load on inanimate objects

A

Disinfectants

56
Q

Chemical agents that reduce microbial load or inhibit growth of microbes on living tissue

A

Antiseptics

57
Q

Chlorhexidine is an antiseptic that has residual activity which means _____

A

efficacy increases with repeated use

58
Q

Cholorhex solution for surgical prep? wound management?

A

Surgical prep - 4% solution

Wound management - 0.05% solution

59
Q

Antiseptic with a one step “scrubless” process = single application & let dry

A

Alcohol based solutions

60
Q

Less effective than povidone iodine or chlorhex

A

Alcohol

61
Q

Disinfectant + Antiseptic that is inactivated by sweat & alcohol, & its effectiveness is decreased by the presence of organic material

A

Povidone-Iodine

62
Q

*Povidone-iodine solution used for wound management? surgical prep?

A 
0.1% - 1% solution - wound management
high concentrations (10%) - may be applied to surgical site during surgical prep
63
Q

Sources of microorganisms

A

Environment
Patient
Surgical team
Surgical equipment

64
Q

*Primary source of bacterial contamination

A

Patient

65
Q

Absence of pathogenic microbes or their toxin in blood or other tissues

A

Asepsis

66
Q

Minimize/prevent contamination of the surgical field

A

Aseptic technique

67
Q

Halstead surgical principles

A 
Asepsis 
Hemostasis 
Accurate anatomical dissection 
Gentle tissue manipulation 
Avoid excess tension on tissue during wound closure
Accurate tissue approx. in wound closure
68
Q

How to reduce the potential for surgical infection non-surgically?

A

Tx existing infections
Minimize hospitalization time (pre & post)
*Clip surgical area, don’t shave

surgical skills (2 decks)

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